Over the last decade, transcatheter aortic valve replacement (TAVR) has emerged as the recommended approach for patients with high and intermediate risk for surgical aortic valve replacement. Even though initial trials demonstrated a higher incidence of conduction abnormalities (CAs), such as left bundle branch block, atrial fibrillation, and permanent pacemaker implantation with TAVR, the incidence of CAs has not decreased. With an increasing number of patients expected to undergo TAVR in the coming decades, even those at low risk for surgical aortic valve replacement, it is important to review the incidence, course, risk factors, mortality, and rehospitalization associated with CAs and permanent pacemaker implantation after TAVR. The newer-generation valves have demonstrated an improved safety profile, but have failed to demonstrate a clinically significant reduction in the incidence of CAs.